Genetic alterations associated with progression from pancreatic intraepithelial neoplasia to invasive pancreatic tumor.

Genetic alterations associated with progression from pancreatic intraepithelial neoplasia to invasive pancreatic tumor.
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DOI:
10.1053/j.gastro.2013.07.049
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发表时间:
2013-11
期刊:
影响因子:
29.4
通讯作者:
Couch FJ
Couch FJ
中科院分区:
医学1区
文献类型:
--
作者:
Murphy SJ;Hart SN;Lima JF;Kipp BR;Klebig M;Winters JL;Szabo C;Zhang L;Eckloff BW;Petersen GM;Scherer SE;Gibbs RA;McWilliams RR;Vasmatzis G;Couch FJ

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Increasing grade of pancreatic intraepithelial neoplasia (PanIN) has been associated with progression to pancreatic ductal adenocarcinoma (PDAC). However, the mechanisms that control progression from PanINs to PDAC are not well understood. We investigated the genetic alterations involved in this process. Genomic DNA samples from laser-capture microdissected PDACs and adjacent PanIN2 and PanIN3 lesions from 10 patients with pancreatic cancer were analyzed by exome sequencing. Similar numbers of somatic mutations were identified in PanINs and tumors, but the mutational load varied greatly among cases. Ten of the 15 isolated PanINs shared more than 50% of somatic mutations with associated tumors. Mutations common to tumors and clonally related PanIN2 and PanIN3 lesions were identified as genes that could promote carcinogenesis. KRAS and TP53 were frequently altered in PanINs and tumors, but few other recurrently modified genes were detected. Mutations in DNA damage response genes were prevalent in all samples. Genes that encode proteins involved in gap junctions, the actin cytoskeleton, the mitogen-activated protein kinase signaling pathway, axon guidance, and cell cycle regulation were among the earliest targets of mutagenesis in PanINs that progressed to PDAC. Early-stage PanIN2 lesions appear to contain many of the somatic gene alterations required for PDAC development.
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